Did you know that up to 25% of breast and ovarian cancers are familial or hereditary? Knowing your family’s health history can be a powerful roadmap for you and your healthcare provider to better understand and manage your breast and ovarian cancer risk proactively.
Since the holiday season is quickly approaching, it’s a great time to begin talking with your relatives- on both parents’ sides if possible- about who had cancer of any kind, which types, and how old they were when diagnosed. While breast and ovarian cancer history are important, other types of cancer can also be indicators- so capture everything you can using our Family Health History form. Then, you’ll be all set to Assess Your Risk, using our tool.
We know this is not always easy. This is why we’ve designed a helpful discussion guide to support you as you seek to learn as much as you can about your family’s health history.
Family History: What to Look Out For
You may be at higher risk if you are a woman with a family history of:
- A close relative with a known genetic mutation associated with an increased or high risk of developing breast or ovarian cancer risk:
- BRCA1, BRCA2
- MSH2, MLH1, EPCAM (Lynch Syndrome)
- PMS2, MSH6 (Lynch Syndrome)
- PMS2, MSH6 (Lynch Syndrome)
- TP53 (Li-Fraumeni Syndrome)
- PTEN (Cowden Syndrome)
- CDH1 (Hereditary Diffuse Gastric and Lobular Breast Cancer Syndrome)
- STK11 (Peutz- Jeghers Syndrome)
Women with a BRCA mutation face up to an 87% lifetime risk for breast cancer and up to a 54% lifetime risk for ovarian cancer- much higher than the general population.
2. Breast cancer diagnosed at age 45 or under
3. Triple-negative (ER-, PR-, HER2-) breast cancer diagnosed at age 60 or under
4. Male breast cancer
5. More than one breast cancer in one relative (cancer in both breasts, or two separate breast cancers in one breast)
6. Two or more relatives with breast cancer, with at least one of the diagnoses at age 50 or under
7. Ovarian cancer, primary peritoneal cancer, or fallopian tube cancer at any age
8. Pancreatic cancer
9. Metastatic Prostate cancer
10. A combination of 3 or more of the following cancers on one side of your family:
- Breast cancer
- Ovarian cancer
- Pancreatic cancer
- Uterine or endometrial cancer
- Stomach, color, or other gastrointestinal cancer
- Thyroid cancer
- Kidney cancer
- Adrenocortical carcinoma
- Brain tumor
Tell Me More: Understanding Hereditary Cancer
A little knowledge about genes can go a long way in helping you understand your risk for hereditary cancer.
Gene mutations associated with both breast and ovarian cancer can run in families. Scientific breakthroughs in the last two decades have uncovered many mutations types including, BRCA1, BRCA2, PALB2, MLH1, TP53, PTEN, STK11, CDH1, CHEK2, and ATM, among other less well-defined gene mutation syndromes.
Genes like BRCA1 and BRCA2 (for breast cancer genes 1 and 2) normally stop breast and ovarian cells from growing and dividing uncontrolled. When an error occurs, or there is a mutation, it can increase the chances of cancer developing. We all have two copies of each gene. As long as at least one BRCA1 and one BRCA2 gene work normally, your risk for cancer won’t be raised; the copies of each gene act as backups for each other. However, if both copies are damaged, your body loses a tool for stopping cancer cells from growing.
Some people are not born with normal genes- they inherit a mutation. Since they don’t have backup protection, any damage to the normal gene can lead to cancer.
The good news is that these mutations can sometimes be discovered through genetic testing, so those that carry them can proactively reduce their risk. If you have a strong family history of breast or ovarian cancer, you should ask your health provider about genetic testing. And if you already have breast or ovarian cancer, understanding whether your cancer is hereditary in nature can impact your family members and help you and your doctors create a more personalized healthcare plan.
The first thing every woman should do is learn as much as she can about her family history and then assess her risk. Once you know your risk, discuss your results with your healthcare provider. If you learn that you are at an increased risk for breast and ovarian cancer, you should consider exploring genetic counseling and testing. If you already have breast or ovarian cancer, learning that it is hereditary can help you and your doctors choose the best treatment plan and follow-up care for you and can inform family members of their potential risks. You can also take advantage of our Ask a Genetic Counselor resource to ask any questions you may have.
Now that you are armed with some great resources and guides, you have the power to be your own best health advocate. It’s up to you to take the next step to manage your health proactively.